It’s time for a new paradigm in healthcare delivery, one that puts patient need before profit without exception. 

The overall healthcare needs of a community have little room for consideration in a system that, in the words of a recent New York Times article, is “moving more rapidly than ever…toward control by corporate interests.” The consequences are devastating: 28 hospitals have closed in New York State since 2000. And with each, New Yorkers have lost access to care.

Cooperatives and communities

Another way is eminently possible. Healthcare cooperatively planned and delivered is the key to putting people where they belong: first. If access to quality care is every person’s – every community’s – right, as RNs believe it is, then healthcare must be coordinated and the quest for profit must be taken out of the equation.

In a cooperative model, local communities, area hospitals, other healthcare institutions, nurses and other caregivers collaboratively determine a community’s healthcare needs and develop and implement plans to meet those needs.

In this approach, decision-making is democratic and all stakeholders, patient advocates and front-line caregivers included, have a real say in shaping what services are provided, where, and how. Hospitals and other key providers create a coordinated network of care that pools expertise, resources, and revenue – all in the interest of meeting the community’s healthcare needs.

Healthcare co-ops in the U.S. are not a fanciful idea. The Rural Wisconsin Health Cooperative, for instance, has been bringing 28 rural hospitals together to share services since 1979, and the hospitals are stronger as a result.

Re-envisioning hospital operations

A cooperative approach belongs in hospitals as well. “Hospitals, public and private alike, have more or less replicated corporate norms,” notes renowned economist Richard Wolff, “and in so doing, they have inherited all the problems that result from a top-down, hierarchical structure: an inefficient, costly, and wasteful administrative layer that has great tension with underlings who have to live with decisions they had no say in making.”

Wolff has devoted years to studying the transformative power of worker/community control and planning its implementation: “The more people have power at work and can participate in decisions about how they work, the better the results. Conventional hospitals miss out on this. Collective self-government would change everything” for patients and caregivers alike.

First steps in New York

NYSNA is working to bring the healthcare cooperative approach to New York. The coalition fighting to save Interfaith has filed legal papers to form the Brooklyn Hospital Cooperative (BHC), with the immediate purpose of keeping Interfaith open as a full-service hospital and the long-term objective of achieving a cooperative, democratic, inclusive approach to assess and meet Brooklyn’s healthcare needs.

In another realm, our program for HHC (see page 5) calls for creating planning councils in each borough that would determine local health needs as a first step toward meeting healthcare needs cooperatively throughout New York City.